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Great news for Daisy and Dawn. Such troubling times when the people (and dogs) we love the most are unwell - but always make sure you take time to celebrate the good news, no matter how small that might be.

Oscar & Bella's Mum
Head Baker for Oscar's Bakery - specialist dog bakery - visit our website for delicious, freshly baked birthday cakes, biscuits and muffins
True believer that life without a Cavalier in it is simply not complete.

We saw Ulreke and spoke about Amitryptiline but after discussing its side effects especially with regards to the heart we quickly dismissed using it .We then went on to discuss
the benefit of Gabapentin and taking Daisy off it completely but decided to continue and it was then suggested introducing Pregabalin in its place but my concern here is that I
don t want to go down the road too far too quick and my thoughts since our last visit are that Daisy's condition is not that far advanced to consider introducing it yet ,by this time
Daisy after exploring all the offices decided to return and she seemed rather bored with events and so settled down by Ulreke and was soon snoring away .After more discussion
about the options open to us and after I advised that Daisy is off to see Simon on Jan 2nd it was agreed that we leave her meds as they are and reconvene on Dec 14 th ,bit
like David Cameron's meetings.

Daisy is still an outward determined little girl with her own individual sense of purpose ,on Thurs I had seven toy chews scattered about and Daisy had four ,Lily was not interested and
Rosie had one and Poppy had one but of course Daisy wanted above all else the one Poppy had so she went over to Poppy stood over her growling till a punch up started and I had to
quickly break it up and put all the chews away ,typical Daisy but thats how I want to keep her the loveable rascal she is.

As I type she has a grip of one of the toys and is busy humping away trying to make lots more little Daisy's for her Dad ,what a thoughtful little girl she is .

Hi
Back to Chestergates tomorrow for an update on Daisy's SM but I see no reason to change her meds but we will see what Ulreke says .We finish for Xmas shut down next Thurs 20 th and back on Wed 2nd Jan so I have booked Daisy to see Simon Swift on Friday 21 st 10.15 am for a complete heart check ECG,Echo and Doppler .She has now developed a slight cough so it might be Vetmedin I dont know this is another big learning curve ,but like all of us I will do everything I can to help her

Hi
Back to Chestergates tomorrow for an update on Daisy's SM but I see no reason to change her meds but we will see what Ulreke says .We finish for Xmas shut down next Thurs 20 th and back on Wed 2nd Jan so I have booked Daisy to see Simon Swift on Friday 21 st 10.15 am for a complete heart check ECG,Echo and Doppler .She has now developed a slight cough so it might be Vetmedin I dont know this is another big learning curve ,but like all of us I will do everything I can to help her

Hope everything is ok with Daisy and her heart is doing ok as well. Hopefully no need to go on any meds yet. I do feel for you and then you have got Dawn to worry about. You are lucky in a way that Chestergate is not far. If I want advice i have to email Clare and sometimes it takes ages so I just muddle through myself. My vet only knows what he has tead on Clares webside. Clare suggested that Rosie might go onto the drug trial. If it is Cambridge.Newmarket I might take all of them there for their SM.

Hi
Back to Chestergates tomorrow for an update on Daisy's SM but I see no reason to change her meds but we will see what Ulreke says .We finish for Xmas shut down next Thurs 20 th and back on Wed 2nd Jan so I have booked Daisy to see Simon Swift on Friday 21 st 10.15 am for a complete heart check ECG,Echo and Doppler .She has now developed a slight cough so it might be Vetmedin I dont know this is another big learning curve ,but like all of us I will do everything I can to help her

Hope everything is ok with Daisy and her heart is doing ok as well. Hopefully no need to go on any meds yet. I do feel for you and then you have got Dawn to worry about. You are lucky in a way that Chestergate is not far. If I want advice i have to email Clare and sometimes it takes ages so I just muddle through myself. My vet only knows what he has tead on Clares webside. Clare suggested that Rosie might go onto the drug trial. If it is Cambridge.Newmarket I might take all of them there for their SM.

Daisy isn't taking anything yet is she? If she has a cough she might be at the point or close to it for starting medications if it means her heart is beginning to struggle a bit on its own and not clearing fluid (maybe she has a mild cough from some other illness at the moment?). Simon Swift will know the right approach for her.

I am not sure I understand the earlier talk on gabapentin -- was there actually a serious consideration of removing Daisy from gabapentin and not giving her Lyrica as an alternative?Or was it only to take her off if she went on Lyrica? I assume the former?

Personally, I would not think of Lyrica s a 'last resort' or using up options -- it is a newer and more efficient version of the old gabapentin, basically and thus would for many many dogs be a better and more efficient drug which isn't needed in as large a dose or generally as many doses -- so is also easier to manage. I'd never think of moving to Lyrica as a case of running out of options if it gives a better response! -- and as others have said, many regret not moving their dog much earlier to Lyrica simply because it is a more effective drug for their particular dog's case of CM/SM. It's like deciding to suffer along on a lower dose painkiller like aspirin when there are many more effective drugs available. There are lots of options to add other drugs alongside Lyrica as well -- hardly a last option. I would really recommend trying it if gabapentin is giving a so-so response now. At the dose of gabapentin Daisy is at, she would pretty much be at her maximum for her size.

Also may I gently suggest that (from experience) I really think it's better not to focus on what might seem 'outward pain' and not mistake that perception as meaning a dog is or isn't "in pain" -- with Daisy, if she needs as high a dose of gabapentin as 200mg 3x -- what my Leo is on and the highest he can go -- then she has significant pain/discomfort of some kind causing her to need that level of neurological painkiller. Leo too is like Daisy in that he mostly just scratches, is very active and outwardly happy -- but I have grown used to seeing that he does have periods of greater discomfort and SM is clearly a burden and he has a significant syrinx now though it doesn't stop him running around or enjoying chews/toys/travel (having just come back from Yorkshire (Laverock Cottages for our third time )and 4-7 mile daily hikes!).

Scratching may not seem 'painful' as an outward response, but dogs are scratching for a reason. As humans say they most commonly experience terrible headache and intolerable skin-crawling sensations (which in my book would qualify as enormous discomfort and pain if I had to live with either) then I think it is hard to assume she is not experiencing pain or significant discomfort? Anyone with neuropathic pain will confirm the pain can be very difficult to tolerate yet not outwardly obvious or expressed and they just get on with life as they have to (there's good evidence with the dogs that they just grow to live with slowly increasing levels of pain too). I know Nicki amongst others -- as someone with significant neuropathic pain -- has said this so many times and the testimonial Tania posted from a Chiari sufferer also underlines this point. I'd aim for relieving her discomfort with whatever works best right now. I would not postpone for long, using something that could make her a lot more comfortable if it is an option, not least as none of us knows how much time our dog has left (as I know having one right now with both SM and MVD -- either could advance rapidly at any time). It would be distressing to find a dog might have done much better on a dfferent medication approach but not have used it because it was being "saved up" for a future that the dog ends up not having. I really advocate giving the best possible treatment as it is needed. .

None of this is easy and it is hard to deal with both afflictions at the same time.